This invention relates to the field of medical instrumentation, and in particular to a data management system utilizing at least one examination instrument capable of storing different forms of data. The system allows upload and download of captured data between the examination instrument(s) and a computer network to create and maintain records and reports.
A number of hand-held diagnostic or examination instruments are known in the medical field for examining a patient, such as those commonly used during routine physician office visits. These instruments include, among others, skin surface microscopes which are used for diagnosing skin disorders, otoscopes permitting examination of the ear canal and tympanic membrane, and ophthalmoscopes for examining the eyes. Each of the above instruments have uniquely inherent features to allow an effective examination of the area of interest. Skin surface microscopes, for example, include a distal optical element having a relatively large diameter (e.g. approximately 15 mm) for direct placement onto a wart, lesion, or other skin disorder. Otoscopes, on the other hand, include a frusto-conical insertion portion having a relatively small diameter (4 mm) optic along with an overlaying safety speculum, which prevents insertion beyond a predetermined distance into the ear canal.
It has since become desirable for a patient to be able to witness a primary care or other examination along with the physician. Therefore, videoized versions of the above diagnostic instruments have been developed, such as those described in U.S. Pat. No. 5,363,839, issued to Lankford, U.S. Pat. No. 5,239,984, issued to Cane, et al, and U.S. Pat. No. 4,947,245, issued to Ogawa, et al. In each of the referenced instruments a miniature video camera, such as a CCD or other electronic sensor, is positioned either within the interior of the instrument or adjacently coupled thereto. The electronic sensor includes a light receiving surface or substrate which receives a focused optical image of a target of interest through a specifically designed viewing system, such as a rod lens, objective or other form of lens, typically positioned in the distal end of the instrument.
A separately disposed light box, or other source of illumination, provides white light through a sheathed cable which is tethered to the proximal end of the instrument. The cable includes an optical fiber bundle for directing the light specifically to the distal tip of the instrument, as well as electrical conductors for powering the electronic sensor. The electronic sensor, in turn, creates an analog or digital electrical signal which is remotely transmitted to a processor containing appropriate circuitry for then converting the transmitted electrical signal into a video monitor-ready (PAL, NTSC) format. The processed video signal is then separately displayed on a remote monitor. The use of videoized systems has become increasingly popular and has since taken on the term xe2x80x9ctelemedicinexe2x80x9d.
Telemedicine systems, like those described above, are quite expensive, with each system requiring a separate diagnostic instrument, along with dedicated cabling, light box, signal processor and video peripheral device(s). In addition, each system also requires a significant space allotment, posing a separate problem in that space is at a premium in physician""s offices and other environments where such systems would be typically be used. It is therefore desirable to provide a telemedicine system which is capable of performing and displaying multiple forms of examinations.
It is another perceived desire in the field to make such telemedicine systems portable. In fact, it is highly desirous to allow examinations to take place outside the xe2x80x9cnormal doctor""s officexe2x80x9d. Along with this need, is a similarly recognized need to allow portions of the system to be compactly arranged without the need for separate peripherals or connecting devices.
Improved organization of patient records is yet another current need in the medical field. To date, creation and maintenance of patient files has been largely a manually managed activity. Data which can form a part of the overall patient record, however, can take on a number of different forms. For example, it has been known that data can be accumulated in a umber of forms, particularly with the advent of telemedicine involving image capture, portions of which might form part of a patient chart or record.
In addition, physicians, such as family practitioners, surgeons, etc., invariably record notes during a patient visit and examination. In some instances, of course, the physician may write information directly into the patient""s file. The usual practice, however, is to record events of an examination using a hand-held recording device. The taped notes are then later transcribed and then added to the patient""s file. Throughout the course of a single day, however, it is possible that a physician may see as many as 40 patients. This kind of volume makes the task of compiling and transcribing notes difficult, or at a minimum time consuming, either for the physician or for the physician""s staff. Reference is herein briefly made to FIG. 12 and 13, broadly depicting a transcription procedure in accordance with the prior art.
More particularly, and prior to a patient encounter, a patient chart is taken from the office files and given to the physician. The physician then examines the patient, adding his or her notes to the file and dictating as needed during the course of examination, typically using a hand-held tape recorder. The physician identifies the patient and adds a time and date stamp at the start of each dictation session. Usually, a single tape will contain dictation relating to a plurality of patient encounters over the course of a typical working day or shift. Often the dictation will be done at the end of the day, when details of the patient visit are sketchy. The doctor must usually rely upon memory, and whatever notes made during the course of examination. As noted, however, a doctor will often see many patients during the day, obscuring the details of a specific visit.
The tape is then sent to a transcriptionist, who listens to the tape, as best understood, and manually types the chart notes. The notes are either into typed into a computer record or onto paper for each patient record on the tape. In any event, a copy of the chart notes are then printed and forwarded to the physician for review. The physician fills in any data which could not be successfully interpreted by the transcriptionist, and otherwise edits the chart notes which are then typed in accordance with the corrections. After again reviewing the chart notes, as necessary, the physician signs off the transcribed record. The record is then added to the patient""s file. The creation of patient records or reports incorporating several different types of data, including audio and video data files, is even more difficult.
A number of potential problems can occur from the above procedure. First, if the tape(s) is faulty or lost, the physician will be required to create the chart records from memory and/or consultation of any written notes which may have been taken during the examination. A similar problem occurs if the tape is prematurely and accidently erased. The audio tape is the primary source of information, which both the transcriptionist and the physician must rely upon for both creating the draft chart notes and for reviewing purposes. The end result is a heightened probability that the records will be incomplete or inaccurate.
In a similar vein, the printed notes could also be lost or misplaced, potentially delaying the reviewing process. Delays obviously will increase the probability that incorrect or incomplete records will be generated. If known video diagnostic instruments such as those shown in FIG. 1 are used, the data obtained from each must also be labeled and separately attached to the file. Based on the amount of time taken, it could be difficult to correctly place this data with the transcribed data, if any. As should be apparent, a myriad of different combinations using various types of data are possible.
To date, though there are known transcripting apparatus available, none conveniently combine audio data with other forms of collected data, such as captured images, sketches by the physician, or other patient or related data obtained from other instruments to be retained and used in compiling and assembling complete examination records which can then be effectively stored and maintained.
Accordingly, it is a primary object of the present invention is to improve the present state of the art of medical examination systems.
It is yet another primary object of the present invention to provide a data management system, for medical or other records, such as inspection, quality control, inventory, etc. using an instrument which is capable of capturing and storing multiple forms of data input. This data can then be effectively transferred into a central network capable of linking the data into accumulated data records which can be updated and maintained automatically.
Yet another primary object of the present invention is to provide an instrument capable of storing various forms of data (i.e.: a multimedia instrument), that can be adaptively interconnected with a plurality of output devices to allow transfer and subsequent processing of a plurality of stored data inputs.
It is yet another primary object of the present invention to provide a medical records (data) management system in which a plurality of captured audio files can be subsequently transferred and transcribed remotely. The transcribed results can then be transferred directly into a patient record along with other data forms relating to a specific patent encounter. The entirety of the data can be stored and/or output into a convenient format which can be printed and added to a patient file.
Therefore and according to a preferred aspect of the present invention, there is provided a method for creating and maintaining records containing at least image, audio data relating to a plurality of subjects using a hand-held multimedia examination instrument having means for capturing various forms of data, the method comprising the steps of:
capturing image data relating to at least one subject of interest using said hand-held multimedia instrument;
capturing audio data corresponding to at least one subject of interest using said multimedia instrument;
capturing control data relating to said at least one subject of interest using said multimedia instrument;
transferring the captured audio and image data from said multimedia instrument to a computer site;
storing said data in a database associated with said computer site;
transferring audio data from said computer site to a transcription site;
transcribing said audio data at said transcription site into text-readable data;
transferring said text-readable data to said computer database for storage; and
incorporating said text-readable data with associated image data as part of a data record.
More preferably, the hand-held multimedia instrument is part of an overall data or records management system. According to a preferred embodiment, the instrument can be interconnected to a receiving cradle or docking station having means for allowing data transfer between the instrument and an external source to allow transfer of audio, video and other data files stored in the instrument or the external source which can, for example, be part of a single computer or computer network. In this manner, protocols, operating instructions, or data from other instruments can be transferred directly to the multimedia instrument according to one embodiment and data and the like can be transferred from the instrument.
In accordance with a preferred embodiment, data is transferred to an intermediate or local PC utilizing software which arranges the data into a scripted template, such as a patient chart of convenient architecture. The template includes allocation for voice, video, annotation and other data and can be stored in a local database. The local database, would for example, contain patient files for a specific physician""s office.
In addition, the transferred voice or WAV files can be further transferred into a network including a data center (e.g. a server) utilizing a global database for tying in a plurality of similar multimedia or other suitable devices. According to a preferred embodiment, the data center can receive and extract a plurality of raw voice data files from a particular instrument, direct the files remotely for transcription and subsequently report all data of a patient encounter, including transcription or consultation data taken from voice inputs, back to the local physician in a suitable record format.
According to a preferred feature, the described data management system utilizes software capable of discriminating a captured video image from known 1D or 2D bar code symbology or for pattern recognizable data. This allows the multimedia instrument to tag data files automatically without requiring separate manual input from the user.
According to yet another preferred embodiment, the multimedia diagnostic instrument includes individual instrument heads, each head including separate and unique viewing optics which focus an optical image onto a contained electronic imager, the imager being preferably situated adjacent the front face of the instrument body.
According to yet another preferred aspect of the present invention, there is described a record management system comprising:
at least one examination instrument including a plurality of instrument heads, wherein at least one of said heads and said instrument body include an optical system for directing an image onto an electronic sensor disposed in said instrument and display means for displaying at least one directed image and data capture means for capturing audio and video data;
means for transferring data files from said instrument to a processing means, said processing means including means for transcribing notes from audio data contained in said files; and for accumulating data into a record format.
According to a preferred aspect, there is described a method for transcribing a plurality of record notes, comprising the steps of:
storing a plurality of data in several forms using a multimedia instrument, said instrument having digital camera means and display means contained therein, as well as means for taking audio data corresponding to a displayed video image;
transferring data from said instrument into a database;
extracting audio data from said transferred data;
moving the audio data files to a central processing station; and
using voice recognition software to process the transcription notes, the software preferably being able to recognize and utilize learn technology based on a given voice being recognized for processing;
creating transcriptions which can be associated with a patient file having at least one video image attributed thereto.
An advantage of the present invention is that a telemedicine system is provided which allows multiple types of examination to be performed in a simple and efficient manner using a single instrument body and interchangeable instrument heads.
Another advantage of the present invention is that multiple instrument heads can be selectively and simply interchanged with a single instrument body to provide versatility and to provide the advantages of multiple videoized systems without a significant impact beyond that of a single dedicated system. Moreover, the instrument is portable, meaning that examinations are not confined to a dedicated location, such as a doctor""s office.
Still another advantage of the present invention is that the described system allows multiple examinations to be performed in a space envelope which is smaller than conventionally known videoized systems. The instrument also includes an integral display and means for compactly storing a series of images, or of displaying real or stored images and playback of captured audio-related data. This capability allows the physician to more efficiently improve the capabilities of the office. In addition, the instrument is preferably linkable to a PC, a PC network or other peripherals capable of using data retrieved from the instrument. Yet, the physician or other user of the instrument can use the videoized instrument from literally any location without restriction, for example, to an office setting.
Still another advantage of the present system is that numerous types of data including imaging data, audio data, and annotation data can be easily stored, transferred, and utilized. This storage allows the creation of a xe2x80x9cmultimediaxe2x80x9d data file and allows efficient creation and maintenance of records provided in a useful format which incorporates each data type within the confines of a specific record.
Yet another advantage is that the above described system can be easily adapted into a multimedia data management system. According to one specific example, a transcription service can be created allowing audio data captured and stored by the instrument(s) to be added into a computer network having voice processing software using a cradle or dictating station which is tied to a local PC which can be linked into the network. As a result, doctors can review records more quickly because the files incorporate image data, allowing the physician to recognize patients faster and recall particular conditions and physiology. An immediate benefit occurs when dictation occurs later after a number of separate patient encounters, and when transcribed notes are reviewed days later.